Tennis ElbowRCTNCT06812377
Comparative Study Between Different Mobilization Techniques for Patients With Chronic Tennis Elbow
A study testing Maitland joint mbilization, mulligan mobilization and radial nerve mobilization in people with Tennis Elbow, run by Prince Sattam Bin Abdulaziz University at 1 site in Saudi Arabia.
Trial summary
Background: Tennis elbow is a common musculoskeletal disorder affecting the functional activities of daily living through common extensor tendinopathy. There is a limited knowledge about neural restriction as a source of movement limitation in patients with tennis other than enriched joint mobilization techniques… Read more about this study
- Who is it for?
- Ages 18 to 50 years
- Conditions the study is for
- Tennis Elbow
- What is being tested?
- Maitland joint mbilization, mulligan mobilization and radial nerve mobilization
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 45 participants
- Where
- 1 siteSaudi Arabia
- Study dates
- 5 Aug 2025to 20 Oct 2025
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 50 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- This study will include individuals between the ages of 18 and 45 who have been diagnosed with lateral epicondylitis based on positive results from the Mill's and Cozen's tests. The participants must also have complaints of local tenderness at the elbow that lasts longer than six weeks. Additionally, to complete the assessment and get treatment, the participants' elbow must have a full extension range of motion
Who cannot join
- Individuals diagnosed with cervical radiculopathy, upper thoracic outlet syndrome, rheumatoid arthritis, myositis ossificans, carpal tunnel syndrome, recent upper limb trauma, elbow immobilization, steroid injection administration within the previous six months, and any history of physical therapy administered within the previous six months were excluded from the study. Furthermore, participation will not be permitted for anyone who has previously experienced discomfort because of their profession
Trial locations and contacts
1 site in 1 country.
Saudi Arabia1 site
Prince Sattam bin Abdulaziz University
Al Kharj, 16242
About this study
Background: Tennis elbow is a common musculoskeletal disorder affecting the functional activities of daily living through common extensor tendinopathy. There is a limited knowledge about neural restriction as a source of movement limitation in patients with tennis other than enriched joint mobilization techniques knowledge.
Objectives: This study will be designed to determine the efficacy of adding different mobilization techniques along with eccentric exercises on elbow pain intensity, functional disability, hand grip strength and pain pressure in patients with chronic tennis elbow.
Read more
Methods: Forty five patients with lateral epicondylitis with their ages ranged from 18 and 45 more than six weeks will be randomly assigned into three groups. Group A will receive Maitland joint mobilization techniques. Patients in group B will receive Mulligan mobilization techniques while patient in group C will receive radial nerve mobilization.. Both groups will receive eccentric exercises for wrist extensors . Patients will be treated three session per week for four week and they will be evaluated pre and post treatment for pain severity using by visual analogue scale, level of functionality by DASH questionnaire, hand grip strength by hand held dynamometer and pressure pain threshold(PPT) by pressure algometer.
Results: All the outcome variables will be assessed at baseline and 4weeks following the treatment period.
- Conditions
- Tennis Elbow
- Being tested
- Maitland joint mbilization, mulligan mobilization, radial nerve mobilization
- Keywords
- Tennis elbow, Grip strength, Pain pressure threshold , Nerve mobilization , Maitland mobilization, Mulligan mobilization
- Medical subject headings
- Tennis Elbow
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Maitland joint mbilizationOther
Posteroanterior mobilization of the radial head in motion. This method is gliding over the radial head posteriorly to anteriorly while the patient executes (and relaxes) the painful action (e.g., clutching). Repeat the method six to ten times if there is a noticeable increase in your ability to grip without pain
mulligan mobilizationOther
Using this approach, the patient performs (and relaxes) the painful action (e.g., clutching) while a lateral humeroulnar auxiliary glide is applied and maintained. If you notice a noticeable increase in your ability to grip without pain, repeat the method six to ten times. You can use a belt to help you glide.Three sets of it were performed, with a 30-second break in between
radial nerve mobilizationOther
The subjects will be placed in a reclining supine position. The arm will be internally rotated, the wrist, thumb, and fingers will be flexed, the shoulder girdle will be depressed, and the elbow will be stretched. Elbow flexion and wrist extension will be used to maintain shoulder depression after the radial nerve will be strained by these motions. Before beginning the gentle elbow extension test, the subject's wrist and fingers will be stabilized. The elbow will be then gently extended for about two seconds, just into the range where the participant felt tension but no pain, and then flexed. In a single session, three sets of six to eight oscillations will be executed
| Study group | Role | What they receive |
|---|---|---|
| group A | Active comparator | maitland mobilization Posteroanterior mobilization of the radial head in motion. This method is gliding over the radial head posteriorly to anteriorly while the patient executes (and relaxes) the painful action (e.g., clutching). Repeat the method six to ten times if there is a noticeable increase in your ability to grip without pain Receives: Other: Maitland joint mbilization |
| Group (B) | Active comparator | mulligan mobilization Using this approach, the patient performs (and relaxes) the painful action (e.g., clutching) while a lateral humeroulnar auxiliary glide is applied and maintained. If you notice a noticeable increase in your ability to grip without pain, repeat the method six to ten times. You can use a belt to help you glide.Three sets of it were performed, with a 30-second break in between [44]. Receives: Other: mulligan mobilization |
| Group (c) | Experimental | radial nerve mobilization Receives: Other: radial nerve mobilization |
What is being measured
The primary outcome is the main question the study is designed to answer.
elbow pain
Assessment of pain intensity will be measured by visual analogue scale (VAS) which consists of a vertical line (0-10) where one end refers to no pain while the other end refers to great pain.) It is a reliable test for literate and illiterate patients 0.94I,0.71 respectively)
Measured: At baseline and after 4 weeks
Hand grip strength
To assess hand grip strength, In order to assess grip strength painlessly, the patient will comfortably sit with their arm at their side, their shoulder adducted and neutrally rotated, their elbow flexed to 90 degrees [38], their forearm in a neutral position, their wrist between 0 and 30 degrees of extension, and their ulnar deviation between 0 and 15 degrees. The greatest grip contraction, expressed in kilograms, shall be noted when no discomfort is felt. The patient will squeeze for three to five seconds, as hard as they can. Multiple trials will be conducted, with an average of three repetitions recorded and a gap of approximately 15 seconds between each trial, to mitigate the possible effect of muscle fatigue
Measured: At baseline and after 4 weeks
Secondary outcomes (2)
pain pressure threshold
Pain Pressure Threshold (PPT) will be measured by pressure algometer by applying the probe tip on the most sensitive poin. Also, three trials will be given, and the average will be taken [39].
A portable device called a pressure algometer is used to measure the pressure-pain threshold. The lowest pressure value at which a person feels pain is known as the pressure-pain threshold [40]. One accurate way to gauge someone's level of discomfort is by using their pressure-pain threshold [41]. A force gauge with a spring-operated plunger is called an algometer. The gauge is fastened to a short metal pole with a rubber tip that is circular and has a diameter of 1 cm. The unit of calibration for the instrument is kilograms of pressure per square centimeter (kg/cm2). The gauge measures between 0 and 10 kg/cm^2. The gadget can be reset to 0 to take a new measurement once one has been taken
Measured: At baseline and after 4 weeks
functionality
Assessment of level of functionality:
A 30-item disability/symptom scale that evaluates the patient's health during the preceding week is the main component of the DASH [36]. The questions include how difficult it is to perform different physical activities due to an arm, shoulder, or hand problem (21 items), how severe each pain symptom is, how much pain, tingling, weakness, or stiffness is related to a particular activity (5 items), and how the problem affects social activities, work, sleep, and one's self-image (4 items). For every item, there are five possible responses. A scale score ranging from 0 (no impairment) to 100 (full disability) (most severe disability) is then obtained by adding the scores for each component
Measured: At baseline and after 4 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted6 Feb 2025
- Study start5 Aug 2025
- Primary completion17 Oct 2025
- Study completion20 Oct 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Tennis ElbowStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 45 participants (actual)
Sponsor and investigators
- Lead sponsor
- Prince Sattam Bin Abdulaziz University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Mohammad Moustafa Aldosoukki Hegazy, Prince Sattam Bin Abdulaziz University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06812377
- Sponsor's protocol ID
- SCBR-393/2024
- Other IDs
- 2024/03/31970
- Acronym
- RCT
- Status last verified
- Nov 2025
- First submitted
- 2 Feb 2025
- Last updated
- 18 Nov 2025
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Vicenzino B, Paungmali A, Teys P. Mulligan's mobilization-with-movement, positional faults and pain relief: current concepts from a critical review of literature. Man Ther. 2007 May;12(2):98-108. doi: 10.1016/j.math.2006.07.012. Epub 2006 Sep 7.
PubMed 16959529Coombes BK, Bisset L, Vicenzino B. Management of Lateral Elbow Tendinopathy: One Size Does Not Fit All. J Orthop Sports Phys Ther. 2015 Nov;45(11):938-49. doi: 10.2519/jospt.2015.5841. Epub 2015 Sep 17.
PubMed 26381484Dorf ER, Chhabra AB, Golish SR, McGinty JL, Pannunzio ME. Effect of elbow position on grip strength in the evaluation of lateral epicondylitis. J Hand Surg Am. 2007 Jul-Aug;32(6):882-6. doi: 10.1016/j.jhsa.2007.04.010.
PubMed 17606071
Study at a glance
From the registry record, last updated by the sponsor on 18 Nov 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparative Study Between Different Mobilization Techniques for Patients With Chronic Tennis Elbow
- ClinicalTrials.gov ID
- NCT06812377
- Acronym / sponsor ID
- RCT / SCBR-393/2024
- Conditions
- Tennis Elbow
- Keywords
- Tennis elbow, Grip strength, Pain pressure threshold , Nerve mobilization , Maitland mobilization, Mulligan mobilization
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 45 participants (actual)
- Lead sponsor
- Prince Sattam Bin Abdulaziz UniversityUniversity, hospital or other
- Study start
- 5 Aug 2025 (actual)
- Primary completion
- 17 Oct 2025 (actual)
- Study completion
- 20 Oct 2025 (actual)
- First posted
- 6 Feb 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Background: Tennis elbow is a common musculoskeletal disorder affecting the functional activities of daily living through common extensor tendinopathy. There is a limited knowledge about neural restriction as a source of movement limitation in patients with tennis other than enriched joint mobilization techniques knowledge.
Objectives: This study will be designed to determine the efficacy of adding different mobilization techniques along with eccentric exercises on elbow pain intensity, functional disability, hand grip strength and pain pressure in patients with chronic tennis elbow.
Methods: Forty five patients with lateral epicondylitis with their ages ranged from 18 and 45 more than six weeks will be randomly assigned into three groups. Group A will receive Maitland joint mobilization techniques. Patients in group B will receive Mulligan mobilization techniques while patient in group C will receive radial nerve mobilization.. Both groups will receive eccentric exercises for wrist extensors . Patients will be treated three session per week for four week and they will be evaluated pre and post treatment for pain severity using by visual analogue scale, level of functionality by DASH questionnaire, hand grip strength by hand held dynamometer and pressure pain threshold(PPT) by pressure algometer.
Results: All the outcome variables will be assessed at baseline and 4weeks following the treatment period.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| group A | Active comparator | Other: Maitland joint mbilizationmaitland mobilization Posteroanterior mobilization of the radial head in motion. This method is gliding over the radial head posteriorly to anteriorly while the patient executes (and relaxes) the painful action (e.g., clutching). Repeat the method six to ten times if there is a noticeable increase in your ability to grip without pain |
| Group (B) | Active comparator | Other: mulligan mobilizationmulligan mobilization Using this approach, the patient performs (and relaxes) the painful action (e.g., clutching) while a lateral humeroulnar auxiliary glide is applied and maintained. If you notice a noticeable increase in your ability to grip without pain, repeat the method six to ten times. You can use a belt to help you glide.Three sets of it were performed, with a 30-second break in between [44]. |
| Group (c) | Experimental | Other: radial nerve mobilizationradial nerve mobilization |
Who may qualify
- Ages
- 18 to 50 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (1 listed)
- This study will include individuals between the ages of 18 and 45 who have been diagnosed with lateral epicondylitis based on positive results from the Mill's and Cozen's tests. The participants must also have complaints of local tenderness at the elbow that lasts longer than six weeks. Additionally, to complete the assessment and get treatment, the participants' elbow must have a full extension range of motion
Key exclusion criteria (1 listed)
- Individuals diagnosed with cervical radiculopathy, upper thoracic outlet syndrome, rheumatoid arthritis, myositis ossificans, carpal tunnel syndrome, recent upper limb trauma, elbow immobilization, steroid injection administration within the previous six months, and any history of physical therapy administered within the previous six months were excluded from the study. Furthermore, participation will not be permitted for anyone who has previously experienced discomfort because of their profession
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Maitland joint mbilizationPosteroanterior mobilization of the radial head in motion. This method is gliding over the radial head posteriorly to anteriorly while the patient executes (and relaxes) the painful action (e.g., clutching). Repeat the method six to ten times if there is a noticeable increase in your ability to grip without pain | Other | group A |
| mulligan mobilizationUsing this approach, the patient performs (and relaxes) the painful action (e.g., clutching) while a lateral humeroulnar auxiliary glide is applied and maintained. If you notice a noticeable increase in your ability to grip without pain, repeat the method six to ten times. You can use a belt to help you glide.Three sets of it were performed, with a 30-second break in between | Other | Group (B) |
| radial nerve mobilizationThe subjects will be placed in a reclining supine position. The arm will be internally rotated, the wrist, thumb, and fingers will be flexed, the shoulder girdle will be depressed, and the elbow will be stretched. Elbow flexion and wrist extension will be used to maintain shoulder depression after the radial nerve will be strained by these motions. Before beginning the gentle elbow extension test, the subject's wrist and fingers will be stabilized. The elbow will be then gently extended for about two seconds, just into the range where the participant felt tension but no pain, and then flexed. In a single session, three sets of six to eight oscillations will be executed | Other | Group (c) |
Primary outcome
elbow pain
Time frame: At baseline and after 4 weeks
Assessment of pain intensity will be measured by visual analogue scale (VAS) which consists of a vertical line (0-10) where one end refers to no pain while the other end refers to great pain.) It is a reliable test for literate and illiterate patients 0.94I,0.71 respectively)
Hand grip strength
Time frame: At baseline and after 4 weeks
To assess hand grip strength, In order to assess grip strength painlessly, the patient will comfortably sit with their arm at their side, their shoulder adducted and neutrally rotated, their elbow flexed to 90 degrees [38], their forearm in a neutral position, their wrist between 0 and 30 degrees of extension, and their ulnar deviation between 0 and 15 degrees. The greatest grip contraction, expressed in kilograms, shall be noted when no discomfort is felt. The patient will squeeze for three to five seconds, as hard as they can. Multiple trials will be conducted, with an average of three repetitions recorded and a gap of approximately 15 seconds between each trial, to mitigate the possible effect of muscle fatigue
2 secondary outcomes
pain pressure threshold
Time frame: At baseline and after 4 weeks
functionality
Time frame: At baseline and after 4 weeks
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 18 Nov 2025.
- Background: PubMed 16959529Vicenzino B, Paungmali A, Teys P. Mulligan's mobilization-with-movement, positional faults and pain relief: current concepts from a critical review of literature. Man Ther. 2007 May;12(2):98-108. doi: 10.1016/j.math.2006.07.012. Epub 2006 Sep 7.
- Background: PubMed 26381484Coombes BK, Bisset L, Vicenzino B. Management of Lateral Elbow Tendinopathy: One Size Does Not Fit All. J Orthop Sports Phys Ther. 2015 Nov;45(11):938-49. doi: 10.2519/jospt.2015.5841. Epub 2015 Sep 17.
- Background: PubMed 17606071Dorf ER, Chhabra AB, Golish SR, McGinty JL, Pannunzio ME. Effect of elbow position on grip strength in the evaluation of lateral epicondylitis. J Hand Surg Am. 2007 Jul-Aug;32(6):882-6. doi: 10.1016/j.jhsa.2007.04.010.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Maitland joint mbilization, mulligan mobilization and radial nerve mobilization in people with Tennis Elbow, run by Prince Sattam Bin Abdulaziz University at 1 site in Saudi Arabia.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 18 Nov 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Saudi Arabia. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
elbow pain (time frame: At baseline and after 4 weeks). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06812377, which also lists 3 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 Nov 2025.